Sr Population Health Program Liaison

Medical Mutual•Cleveland, OH

5d•Hybrid

About The Position

Provider-Focused Liaison serves as a strategic partner to key providers and internal provider teams, supporting the advancement of care management and population health initiatives. Responsible for driving improvements in quality, cost performance, and member outcomes through consultative collaboration. Assists in the development, coordination, and implementation of clinical and strategic initiatives, aligning provider efforts with organizational goals and value-based care models.

Requirements

Graduate of a registered nursing program approved by the Ohio State Nursing Board.
Bachelor’s Degree preferred.
In lieu of RN, Bachelor’s degree in business or health care administration or related field.
Masters degree preferred.
5 years experience partnering with provider groups, health systems, and/or employer groups to advance clinical initiatives or equivalent relevant experience in the healthcare or health insurance industry.
Registered Nurse with current State of Ohio unrestricted license preferred.
Comprehensive knowledge of healthcare cost drivers and factors impacting participant satisfaction.
Comprehensive knowledge of population health and/or value-based care concepts
Knowledge of health insurance regulations (Centers for Medicare & Medicaid Services (CMS), State of Ohio) and National Committee for Quality Assurance (NCQA) accreditation guidelines.
Strong project management skills.
Strong written and verbal communication and presentation skills.
Intermediate to advanced Microsoft Office skills.

Responsibilities

Collaborates with providers and health systems to implement programs that improve care quality and reduce costs for at-risk populations.
Executes clinical initiatives to align with strategic and contractual goals through Cross-Functional Collaboration (CQHS, Sales, Marketing, Provider Network, etc.).
Monitors and interprets Clinical program data to identify trends in medical utilization and clinical outcomes.
Analyzes clinical cases and prepares documentation for case conferences with care management and population health teams.
Builds and maintains clinical relationships through regular meetings and communication.
Participates in divisional events and initiatives that support the organization’s strategic plan.
Performs other duties as assigned.

Benefits

We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
On-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available.
On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
Discounts at many places in and around town, just for being a Medical Mutual team member.
The opportunity to earn cash rewards for shopping with our customers.
Business casual attire, including jeans.
Employee bonus program.
401(k) with company match up to 4% and an additional company contribution.
Health Savings Account with a company matching contribution.
Excellent medical, dental, vision, life and disability insurance.
Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
Parental leave for eligible employees who become parents through maternity, paternity or adoption.
Career development programs and classes.
Mentoring and coaching to help you advance in your career.
Tuition reimbursement up to $5,250 per year, the IRS maximum.
Diverse, inclusive and welcoming culture with Business Resource Groups.